What Is an Authorized Treating Physician in an Alabama Workers Compensation Case?

What Is an Authorized Treating Physician in an Alabama Workers Compensation Case?

If you have been injured at work in Alabama, you will likely hear the term Authorized Treating Physician. This is a term of art, and most injured workers simply refer to this physician as “the workers’ comp doctor.”  But who is this doctor, and why are they so important to your claim?

What Is an Authorized Treating Physician?

An Authorized Treating Physician (ATP) is the doctor selected by your employer or its workers’ compensation insurance carrier to direct your medical treatment following a compensable work injury.

Under Alabama workers’ compensation law, the employer generally has the right to choose the initial physician who will treat an injured worker (in emergency situations workers comp may not have time to select an initial treating physician). This surprises many people because when they are sick or injured outside of work, they are accustomed to choosing their own doctor, but Alabama workers’ compensation claims operate differently.

Why Is the Authorized Treating Physician So Important?

The Authorized Treating Physician does much more than simply provide medical treatment. The ATP often makes decisions that affect nearly every aspect of your workers’ compensation claim, including:

• what treatment is necessary,
• whether diagnostic testing such as an MRI should be performed,
• whether a referral to see a specialist is warranted,
• whether physical therapy should be ordered,
• whether surgery is needed,
• whether you can return to work,
• what work restrictions should be assigned,
• whether you have reached Maximum Medical Improvement (MMI)

In many cases, the physician’s opinions significantly influence how the workers’ compensation insurance carrier handles the claim.

Who Pays for My Medical Treatment?

If your injury is covered under Alabama’s Workers’ Compensation Act, the workers’ compensation insurance carrier is generally responsible for paying for all reasonably necessary medical treatment related to the work injury.

This may include:

• doctor visits
• surgery
• physical therapy
• prescription medications
• medical equipment
• diagnostic testing
• rehabilitation services

As long as the treatment is authorized and considered reasonably necessary, these expenses are to be paid by workers’ compensation.

Can the Authorized Treating Physician Refer Me to Specialists?

Yes, if the Authorized Treating Physician believes specialized treatment is necessary, they may refer you to another physician or specialist.

Common referrals include:

• orthopedic surgeons
• neurosurgeons
• pain management specialists
• neurologists
• physical medicine and rehabilitation physicians
• psychiatrists or psychologists

Once the referral is properly authorized, the specialist often becomes you Authorized Treating Physician.

Can I Choose My Own Doctor?

You are always free to seek treatment from a physician of your own choosing; however, there is an important distinction: The workers’ compensation insurance carrier is generally only required to pay for treatment provided or authorized through the authorized treating physician, and most personal health insurance policies specifically exclude treatment for work-related injuries. As a result, seeking treatment outside the workers’ compensation system may create significant out-of-pocket expenses.

What If I Am Unhappy With My Authorized Treating Physician?

Alabama law provides injured workers with certain rights if they become dissatisfied with their physician.

In many situations, an injured worker may request what is known as a Panel of Four, which allows the worker to select a replacement physician from a list provided by the workers’ compensation insurance carrier. Because the authorized treating physician plays such an important role in the claim, choosing a new physician can sometimes have a significant impact on both medical treatment and the overall direction of the case and is not something to be done without serious consideration.

The Authorized Treating Physician is one of the most important people in an Alabama workers’ compensation claim, and understanding the role of the Authorized Treating Physician can help you better understand the workers’ compensation process and what to expect as your claim progresses.

Questions About Your Medical Treatment?

If you have suffered a job injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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